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According to standard dogma based on animal studies and case reports suggesting risk for ophthalmic complications, tetracaine should not be given to patients with corneal abrasions. However, prior research suggests that topical anesthetics are safe for such patients (NEJM JW Emerg Med Jun 2014 and Acad Emerg Med 2014; 21:374). Now, investigators at a single ED in New Zealand conducted an observational study spanning a 21-month period before and after tetracaine was allowed for treatment of corneal abrasion patients. Those who received tetracaine were instructed to use the agent for no more than 24 hours.
During the study period, 1576 initial ED presentations for corneal abrasion occurred, with 532 deemed “simple” and 1044 deemed “nonsimple” …